Abdominal Emergency
An abdominal emergency typically presents with severe abdominal pain along with other symptoms. Even the most advanced medical facilities may find it difficult to quickly examine and accurately diagnose an abdominal emergency in Kolkata. The best abdominal specialist, Dr. Mainak Pal, concentrates on examining the severity of a patient’s condition. He then manages it properly by identifying critical patients and immediately commencing treatment. While severe abdominal pain can occur due to many reasons, a structured approach should be adopted, involving initial assessment followed by an immediate medical therapy or surgical intervention.
Some Abdominal Emergencies Requiring Urgent Intervention
- Internal Bleeding: Some of the most common causes of internal abdominal bleeding are bleeding gastric ulcer, ruptured ectopic pregnancy, and trauma. Clinical signs include hypotension and tachycardia, clammy and pale on inspection, as well as cool to touch.
- Perforated Viscus: The inflammation of peritoneum (called peritonitis) is commonly caused by a perforated viscus. Perforation may occur due to small or large intestinal obstruction, peptic ulceration, inflammatory bowel disease, and diverticular disease. Patients with perforated viscus show signs of tachycardia, completely rigid abdomen, reduced bowel sounds, and involuntary guarding.
- Ischaemic Bowel: It occurs when the artery supplying blood to the colon becomes narrowed or blocked. Patients typically complain of a diffuse or constant ache and accurate diagnosis is through CT scan with Intravenous contrast.
- Colic: The abdominal pain associated with this condition becomes very severe at one point and then completely goes away. Among the different types of colic, ureteric, bowel obstruction, and biliary colic are the most common.
- Peritonism: It is the localised inflammation of the patient’s peritoneum that occurs due to an inflamed viscus, causing irritation of the visceral peritoneum.
Diagnosis of Abdominal Pain
The exact location of the patient’s abdominal pain is a useful feature used for narrowing down the diagnosis. An experienced abdominal emergency doctor would also consider extra-abdominal organs to find out the possible causes for abdominal pain, including respiratory, gynaecological, and cardiac conditions.
The following laboratory tests may be used for assessing the patient’s condition:
- Urine dipstick: It detects signs of infection
- Routine blood tests: LFTs, FBC, CRP, U&Es, and amylase lipase
- Arterial blood gas: Used in septic or bleeding patients
After assessing the condition, Dr. Pal might recommend imaging for accurate diagnosis.
- Erect chest radiograph
- Ultrasound of ureters, kidneys, bladder, liver, and biliary tree
- Abdominal CT imaging
Abdominal Pain Treatment in Kolkata
When it comes to managing acute abdominal pain, Dr. Mainak Pal works out an effective initial management plan that includes core points, irrespective of the underlying causes. Treatment includes intravenous access, analgesia +/- antiemetic, NBM status set, initial imaging, urine dip, blood tests, and VTE prophylaxis and surgery if needed.